A randomized controlled trial comparing two vocational models for persons with severe mental illness

Authors: Bootes, K. & Chapparo, C.
Year Published 2007
Publication Journal of Consulting and Clinical Psychology
Volume 75
Number 6
Pages 968-982
Publisher The American Psychological Association

Most individuals with severe mental illness (SMI) express a desire to work in competitive jobs, defined as regular community jobs, with nondisabled coworkers, paying minimum wage or higher (McQuilken et al., 2003). Yet surveys typically have found competitive employment rates of 15% or less in this population (Rosenheck et al., 2006; Salkever et al., 2007) pg. 968


The purpose of this study was to compare two vocational rehabilitation models for individuals with severe mental illness. The Individual Placement and Support (IPS)model of supported employment and the Diversified Placement Approach (DPA)were reviewed and compared.


This report examined vocational outcomes for clients enrolled in Thresholds, a large psychiatric rehabilitation agency in Chicago, IL.


The sample was 187 clients with severe mental illness.

Data Collection

Data were obtained through participant interviews, chart review, information from staff and agency records, direct queries to Thresholds staff (to corroborate other data sources), Medicaid claims, and hospital discharge forms.


Clients were assigned to one of two groups (IPS or DPA) for employment services.


IPS had significantly better competitive employment outcomes than DPA. Competitive employment rates over the 2-year follow up were 75.0% for IPS and 33.7% for DPA. However, IPS and DPA did not differ on paid employment outcomes.


The authors conclude that IPS is more effective than DPA in achieving competitive employment, but not paid employment.

URL http://www.ncbi.nlm.nih.gov/pubmed/18085913
Disabilities Emotional disturbance
Populations Male & Female
Outcomes Employment acquisition | Full-time employment | Part-time employment
Research Design Randomized Controlled Trials (RCTs)
Peer Reviewed Yes